Derek Sandoval

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

54702 Issued in NM

Practice address

1100 Central Ave SE
Albuquerque, NM 87106-4934

Phone

(505) 724-6125

Fax

(505) 724-6125

NPI assigned

Feb 8, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dsandoval278877@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Medical Associates, LLC

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  Medicare reassignment Care Compare group NPD
• Southwest Medical Associates, LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1578255253
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lovelace Health System LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1306914213
  Care Compare affiliation
• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1740745249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064934",
            "telephone_number": "505-724-6125",
            "fax_number": "505-724-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064934",
            "telephone_number": "505-724-6125",
            "fax_number": "505-724-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "54702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Sandoval, M.D.
• Andrew Sandoval
• Clarissa A Sandoval
• Cristie Sandoval, PHARMD
• Dennis M Sandoval, M.D.
• Dora J Sandoval, LMSW
• Edna V Sandoval, RPH
• Elizabeth Sandoval, LMT
• Gary Lee Sandoval
• Hurbina Sandoval, R.N.

• Acute Care Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Acute Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.